Study Shows Xolair May Be Effective for Children Who Are Severely Allergic to Milk
By Brenda Goodman
WebMD Health News
Reviewed by Laura J. Martin, MD
March 21, 2011 -- A small new study suggests that children with severe milk allergies may be able to rapidly overcome their sensitivities with the help of a biologic drug that helps to quiet an overly aggressive immune response.
The study appears to be so promising that if larger trials, which are under way, are able to duplicate the results, the drug, Xolair, might become the first treatment to help the increasing numbers of kids who react to common foods like milk, egg, or peanuts.
Researchers who were not involved with the study called the results "interesting but very preliminary," says Scott H. Sicherer, MD, professor of pediatrics at Mount Sinai School of Medicine's Jaffe Food Allergy Institute in New York.
"This drug may make it easier to give oral immunotherapy with fewer side effects, but more studies are clearly needed," Sicherer tells WebMD.
The study was presented at the annual meeting of the American Academy of Allergy and Asthma and Immunology in San Francisco.
Preventing Life-Threatening Food Allergies
Researchers at Children's Hospital Boston and Stanford University enrolled 11 children between the ages of 7 and 17 with milk allergies so severe that even tiny amounts would cause hives, vomiting, facial swelling, and possibly anaphylaxis, a potentially life-threatening reaction.
For nine weeks, they gave the children injections of the biologic drug Xolair, which blocks the immune protein IgE, an important chemical signal that causes specialized cells called mast cells to release a host of chemicals that cause swelling, itching, and other signs of an allergic reaction.
Over the next two to three months, the kids continued the medication. In addition they were given ever greater amounts of milk to drink each day, working up to about 2 ounces of milk daily.
For the next two months, the kids continued drinking their 2 ounces of milk each day.
Nine of the 11 children successfully completed the study.
At the study's end, after six months, the researchers challenged the remaining nine children with a full 8-ounce glass of milk or a placebo drink. All nine were successfully able to drink the milk.
"It's life changing," says study researcher Dale Umetsu, MD, PhD, the Prince Turki al Saud Professor of Pediatrics in the division of immunology at Children's Hospital Boston. "Now they can eat pizza and ice cream with their friends. It's a very important change to their lifestyle."
Umetsu notes that all the children in the study had very severe allergies. On lab tests which rank how allergic someone is to a given substance on a scale from 1 to 100, with 100 being the most severe, the average score for participants was about 90.
Genentech, the company that makes Xolair, donated the medication for the study, which can cost $500 to $2,000 a month.
Outgrowing Allergies Without Medication
In another study presented at the meeting -- the first to follow kids allergic to milk and watch what happens as they grow -- researchers tracked 244 milk-allergic children who ranged in age from 3 months to 15 months.
After 2 1/2 years, 89 had outgrown their allergy, indicating that kids who are allergic to milk as babies and toddlers have about a 40% chance of getting over their sensitivities without any special treatment by the time they're in grade school.
Researchers noted that children who had very severe eczema, a flaky, itchy skin condition, or a very high score on their allergy tests were less likely than others to outgrow their allergies.
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SOURCES: Nadeau, K. Journal of Allergy and Clinical Immunology, February 2011.News release, American Academy of Allergy, Asthma and Immunology.Scott H. Sicherer, MD, professor of pediatrics, Mount Sinai School of Medicine's Jaffe Food Allergy Institute, N.Y.Dale Umetsu, MD, PhD, Prince Turki al Saud Professor of Pediatrics, division of immunology, Children's Hospital Boston.
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